Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta-analysis

Objective: Our review analyses the studies that have specifically compared the association iDPP4/metformin with glimepiride/metformin, both in second line pharmacotherapy of type 2 diabetes mellitus (DM2). Methods: Systematic literature review with a meta-analysis of clinical trials comparing glimepiride with any iDPP4, both used together with metformin as a second line treatment of DM2. The effectiveness variables used were as follows: %HbA1c variation, fasting plasma glucose variation, patients achieving the therapeutic objective of HbA1c <7%, treatment dropouts due to lack of effectiveness and rescue treatments needed. The safety variables included were as follows: weight variation at the end of treatment; presentation of any type of adverse event; presentation of serious adverse events; patients who experienced any type of hypoglycaemia; patients who experienced severe hypoglycaemia; treatments suspended due to adverse effects; and deaths for any reason. Results: Four studies met the inclusion criteria. The group treated with glimepiride showed better results in all effectiveness variables. Regarding safety variables, the main differences observed were in the greater number of cases with hypoglycaemia in the group treated with glimepiride, and the serious adverse events or treatment discontinuations due to these which occurred in slightly over 2% more cases in this group compared to the iDPP4 group. The remaining adverse events, including mortality, did not show any differences between both groups. The variation in the weight difference between groups (2.1 kg) is not considered clinically relevant. Conclusions: A greater effectiveness is seen in the glimepiride/metformin association, which should not be diminished by slight differences in adverse effects, with absence of severe hypoglycaemia in over 98% of patients under treatment. The association of glimepiride/metformin, both due to cost as well as effectiveness and safety, may be the preferential treatment for most DM2 patients, and it offers a potential advantage in refractory hyperglycemic populations, tolerant to treatment.S

Production Response and Digestive Enzymatic Activity of the Pacific White Shrimp Litopenaeus vannamei (Boone, 1931) Intensively Pregrown in Microbial Heterotrophic and Autotrophic-Based Systems

Shrimp postlarvae were reared into different microcosm systems without water exchange; a traditional system based on simple fertilization to improve microalgae concentration (control), an autotrophic system (AS) based on the promotion of biofloc and biofilm by the addition of fertilizer and artificial substrates and a heterotrophic system (HS) based on the promotion of heterotrophic bacteria by the addition of nitrogenous and carbonaceous sources and artificial substrates. Better growth performance and survival were registered in shrimp from the AS and HS compared to the control. Feed conversion ratios were below 0.7 for all treatments, but AS and HS were significantly lower than the control. Regarding digestive performance, no significant differences were observed for trypsin, amylase and lipase activities among AS and control shrimp; however, shrimp from HS showed a higher trypsin and amylase activities, suggesting a higher digestive activity caused by the presence of microbial bioflocs. The presence of biofilm and bioflocs composed by either autotrophic or heterotrophic organisms in combination with formulated feed improved the growth performance and survival of shrimp. Apparently, such combination fits the nutritional requirements of shrimp

Properties of iron-modified-by-silver supported on mordenite as catalysts for nox reduction

A series of mono and bimetallic catalysts based on a Fe-Ag mixture deposited on mordenite was prepared by ion-exchange and evaluated in the catalytic activity test of the de-NOx reaction in the presence of CO/C3H6. The activity results showed that the most active samples were the Fe-containing ones, and at high temperatures, a co-promoter effect of Ag on the activity of Fe catalysts was also observed. The influence of the order of cation deposition on catalysts formation and their physicochemical properties was studied by FTIR (Fourier Transform Infrared Spectroscopy) of adsorbed NO, XANES (X-ray Absorption Near-Edge Structure), and EXAFS (Extended X-ray Absorption Fine Structure) and discussed in terms of the state of iron. Results of Fe K-edge XANES oscillations showed that, in FeMOR catalysts, iron was present in a disordered state as Fe3+ and Fe2+. In FeAgMOR, the prevailing species was Fe3+, while in the AgFeMOR catalyst, the state of iron was intermediate or mixed between FeMOR and FeAgMOR. The Fe K-edge EXAFS results were characteristic of a disordered phase, the first coordination sphere being asymmetric with two different Fe-O distances. In FeAgMOR and AgFeMOR, coordination of Fe-O was similar to Fe2O3 with a few amount of Fe2+ species. We may conclude that, in the bimetallic FeAgMOR and AgFeMOR samples, a certain amount of tetrahedral Al3+ ions in the mordenite framework is replaced by Fe3+ ions, confirming the previous reports that these species are active sites for the de-NOx reaction. Based on the thermodynamic analysis and experimental data, also, it was confirmed that the order of deposition of the components influenced the mechanism of active sites&rsquo; formation during the two steps ion-exchange synthesis

Comparative study of ornamental granite cleaning using femtosecond and nanosecond pulsed lasers

Granite has been widely used as a structural and ornamental element in public works and buildings. In damp climates it is almost permanently humid and its exterior surfaces are consequently biologically colonized and blackened We describe a comparative analysis of the performance of two different laser sources in removing biological crusts from granite surfaces: nanosecond Nd:YVO4 laser (355 nm) and femtosecond Ti:Sapphire laser at its fundamental wavelength (790 nm) and second harmonic (395 nm). The granite surface was analyzed using scanning electron microscopy, attenuated total reflection – Fourier transform infrared spectroscopy and profilometry, in order to assess the degree of cleaning and to characterize possible morphological and chemical changes caused by the laser sources.This work is supported by the CTM2010-19584, FIS2009-09522 and CSD2007-00013 research projects (Ministerio de Ciencia y Tecnología, Spanish Government) and by SA086A12-2 project (Junta de Castilla y León, Spain). FTIR, profilometry and SEM analyses were conducted at the University of Vigo's research centre (CACTI)

Visceral fat area and cardiometabolic risk: The Kardiovize study

BACKGROUND: Visceral fat is associated with adiposity-based complications. Bioimpedance measurement allows estimation of visceral fat area (VFA) in an easy manner. However, a validated cut-off value for VFA by bioimpedance associated with cardiometabolic risk is lacking in European population. AIM: To determine cut-off values of VFA measured via bioimpedance associated with cardiometabolic risk. METHODS: Random cross-sectional Czech population-based sample of 25-64 years old subjects. Receiver Operating Characteristic (ROC) curves were used and the area under the curve (AUC), sensitivity, and specificity were calculated. The Cardiometabolic Disease Staging System (CMDS) was used to classify cardiometabolic risk: Stage 1 - 1 or 2 metabolic syndrome (MetS) components, without impaired fasting glucose (IFG); Stage 2 - MetS or IFG; Stage 3 - MetS with IFG; Stage 4 - type 2 diabetes and/or cardiovascular disease. RESULTS: 2052 participants (54.5% females, median age 49 years) were included. Median VFA (inter-quartile range) were 82.2 cm2 (54.8) in men and 89.8 cm2 (55.6) in women. The best VFA cut-offs associated with Stage 1 in men and women were 71 cm2 (sensitivity = 0.654; specificity = 0.427) and 83 cm2 (sensitivity = 0.705; specificity = 0.556) ; Stage 2: 84 cm2 (sensitivity = 0.673; specificity = 0.551) and 98 cm2 (sensitivity = 0.702; specificity = 0.628) ; Stage 3: 90 cm2 (sensitivity = 0.886; specificity = 0.605) and 109 cm2 (sensitivity = 0.755; specificity = 0.704); Stage 4: 91 cm2 (sensitivity = 0.625; specificity = 0.611) and 81 cm2 (sensitivity = 0.695; specificity = 0.448), respectively. CONCLUSION: A cut-off value of VFA of 71 cm2 in men and 83 cm2 in women exhibited the earliest stage of cardiometabolic risk, and 90 cm2 in men and 109 cm2 in women showed the best performance to detect risk

Angular redistribution of near-infrared emission from quantum dots in 3D photonic crystals

We study the angle-resolved spontaneous emission of near-infrared light sources in 3D photonic crystals over a wavelength range from 1200 to 1550 nm. To this end PbSe quantum dots are used as light sources inside titania inverse opal photonic crystals. Strong deviations from the Lambertian emission profile are observed. An attenuation of 60 % is observed in the angle dependent radiant flux emitted from the samples due to photonic stop bands. At angles that correspond to the edges of the stop band the emitted flux is increased by up to 34 %. This increase is explained by the redistribution of Bragg-diffracted light over the available escape angles. The results are quantitatively explained by an expanded escape-function model. This model is based on diffusion theory and adapted to photonic crystals using band structure calculations. Our results are the first angular redistributions and escape functions measured at near-infrared, including telecom, wavelengths. In addition, this is the first time for this model to be applied to describe emission from samples that are optically thick for the excitation light and relatively thin for the photoluminesence light.Comment: 24 pages, 8 figures (current format = single column, double spaced

MadQCI: a heterogeneous and scalable SDN QKD network deployed in production facilities

Current quantum key distribution (QKD) networks focus almost exclusively on transporting secret keys with the highest possible rate. Consequently, they are built as mostly fixed, ad hoc, logically, and physically isolated infrastructures designed to avoid any penalty to the quantum channel. This architecture is neither scalable nor cost-effective and future, real-world deployments will differ considerably. The structure of the MadQCI QKD network presented here is based on disaggregated components and modern paradigms especially designed for flexibility, upgradability, and facilitating the integration of QKD in the security and telecommunications-networks ecosystem. These underlying ideas have been tested by deploying many QKD systems from several manufacturers in a real-world, multi-tenant telecommunications network, installed in production facilities and sharing the infrastructure with commercial traffic. Different technologies have been used in different links to address the variety of situations and needs that arise in real networks, exploring a wide range of possibilities. Finally, a set of realistic use cases have been implemented to demonstrate the validity and performance of the network. The testing took place during a period close to three years, where most of the nodes were continuously active

Connecting Network Properties of Rapidly Disseminating Epizoonotics

To effectively control the geographical dissemination of infectious diseases, their properties need to be determined. To test that rapid microbial dispersal requires not only susceptible hosts but also a pre-existing, connecting network, we explored constructs meant to reveal the network properties associated with disease spread, which included the road structure.Using geo-temporal data collected from epizoonotics in which all hosts were susceptible (mammals infected by Foot-and-mouth disease virus, Uruguay, 2001; birds infected by Avian Influenza virus H5N1, Nigeria, 2006), two models were compared: 1) 'connectivity', a model that integrated bio-physical concepts (the agent's transmission cycle, road topology) into indicators designed to measure networks ('nodes' or infected sites with short- and long-range links), and 2) 'contacts', which focused on infected individuals but did not assess connectivity.THE CONNECTIVITY MODEL SHOWED FIVE NETWORK PROPERTIES: 1) spatial aggregation of cases (disease clusters), 2) links among similar 'nodes' (assortativity), 3) simultaneous activation of similar nodes (synchronicity), 4) disease flows moving from highly to poorly connected nodes (directionality), and 5) a few nodes accounting for most cases (a "20:80" pattern). In both epizoonotics, 1) not all primary cases were connected but at least one primary case was connected, 2) highly connected, small areas (nodes) accounted for most cases, 3) several classes of nodes were distinguished, and 4) the contact model, which assumed all primary cases were identical, captured half the number of cases identified by the connectivity model. When assessed together, the synchronicity and directionality properties explained when and where an infectious disease spreads.Geo-temporal constructs of Network Theory's nodes and links were retrospectively validated in rapidly disseminating infectious diseases. They distinguished classes of cases, nodes, and networks, generating information usable to revise theory and optimize control measures. Prospective studies that consider pre-outbreak predictors, such as connecting networks, are recommended